Based on estimates of federal funding levels for Medicaid once the federal economic stimulus boost is gone, Idaho's Medicaid program is looking at having to cut costs by $387 million - about 23 percent of the Medicaid program. Various savings efforts already are under way. But Idaho Health & Welfare Director Dick Armstrong said, "The dilemma is this: Even with all of this cost-containment activity, we are looking at a shortfall that is just extreme." He said, "That is going to be extremely painful."

Stunned lawmakers on JFAC had no questions at the end of Armstrong's presentation. "I think we just all have our breath taken away already this morning," said Co-Chairman Dean Cameron, R-Rupert. "We'll look forward to working with you, to try and figure out a way out of this situation."